The Relationship between Health Literacy, Self-Efficacy, Health Perception and Perceived Service Quality in Primary Care Patients with Chronic Disease

Year 2024, Volume: 13 Issue: 1, 51 - 59, 20.03.2024

Cennet Çiriş Yıldız , Dilek Yıldırım , Tansu Birinci , Duygu Dokumacı

https://doi.org/10.53424/balikesirsbd.1342119

Cited By: 1

Abstract

Objective: The present study aimed to investigate the relationship between health literacy, self-efficacy, health perception, and perceived service quality in patients with chronic diseases who applied to primary healthcare services. Materials and Methods: Seven hundred and eighty-two (495 female, mean age; 55.39±18.39 years) participants with chronic diseases were included. Health literacy and health perception were evaluated using Turkish Health Literacy Scale-32 (THLS-32), and Health Perception Scale (HPS), respectively. Self-Efficacy Scale on Chronic Diseases (SESCD) was used to assess self-efficiency level and SERVPERF scale was assess the perceived service quality. Results: There were significant relationships between THLS-32, age, SERVPERF, and SESCD (p<0.05). HPS was significantly correlated with age, the number of chronic diseases, and SERVPERF (p<0.05). THLS-32, HPS, age, and the number of chronic diseases explained a significant amount of variance in all subscales of SESCD (p<0.05), describing 9.7% to 16.5% of the adjusted R2. Health literacy, health perception, age, and the number of chronic diseases explained a significant amount of variance in all subscales of SERVPERF (p<0.05), describing 4.4% to 8.1% of the adjusted R2. Conclusion: This study found that health literacy, age, and the number of chronic diseases were predictors of self-efficacy; in addition, health literacy, health perception, age, and the number of chronic diseases were predictors of perceived service quality in patients with chronic diseases. Age and number of chronic diseases are non-modifiable factors for the level of self-efficacy and perceived service quality whereas health literacy can be improved.

Keywords

Health Literacy, Health Perception, Primary Care, Self-Efficacy, Service Quality

Supporting Institution

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Project Number

-

Thanks

-

Birinci Basamak Sağlık Kuruluşlarına Başvuran Kronik Hastalarda Sağlık Okuryazarlığı, Öz-Etkililik, Sağlık Algısı ve Algılanan Hizmet Kalitesi Arasındaki İlişki

Abstract

Amaç: Bu çalışmada birinci basamak sağlık hizmetlerine başvuran kronik hastalığı olan hastalarda sağlık okuryazarlığı, öz-etkililik, sağlık algısı ve algılanan hizmet kalitesi arasındaki ilişkinin belirlenmesi amaçlanmıştır. Gereç ve Yöntem: Çalışmaya kronik hastalığı olan 782 (495 kadın, ortalama yaş; 55,39±18,39) katılımcı dâhil edildi. Sağlık okuryazarlığı ve sağlık algısı sırasıyla Türkiye Sağlık Okuryazarlığı Ölçeği (TSOY-32) ve Sağlık Algısı Ölçeği (SAÖ) kullanılarak değerlendirilmiştir. Öz-etkililik düzeyini değerlendirmek için Kronik Hastalıklarda Öz-Etkililik Ölçeği (KHÖEÖ), algılanan hizmet kalitesini değerlendirmek için SERVPERF ölçeği kullanıldı. Bulgular: TSOY-32, yaş, SERVPERF ve KHÖEÖ arasında anlamlı ilişki vardı (p<0.05). SAÖ, yaş, kronik hastalık sayısı ve SERVPERF ile anlamlı korelasyon gösterdi (p<0.05). TSOY-32, SAÖ, yaş ve kronik hastalık sayısı, düzeltilmiş R2'nin %9,7 ile %16,5’ini tanımlayarak KHÖEÖ'nin tüm alt ölçeklerinde önemli miktarda varyansı açıklamıştır (p<0.05). Sağlık okuryazarlığı, sağlık algısı, yaş ve kronik hastalık sayısı, düzeltilmiş R2'nin %4,4 ile %8,1'ini tanımlayarak SERVPERF'in tüm alt ölçeklerinde önemli miktarda varyansı açıkladı (p<0.05). Sonuç: Bu çalışmada, kronik hastalığı olan hastalarda sağlık okuryazarlığı, yaş ve kronik hastalık sayısının öz-etkililiğin prediktörleri; sağlık okuryazarlığı, sağlık algısı, yaş ve kronik hastalık sayısının algılanan hizmet kalitesinin prediktörleri olduğu bulundu. Yaş ve kronik hastalık sayısı, öz-etkililik düzeyi ve algılanan hizmet kalitesi için değiştirilemez faktörlerken, sağlık okuryazarlığı geliştirilebilir bir faktördür.

Keywords

Sağlık Okuryazarlığı, Sağlık Algısı, Birinci Basamak, Öz Etkililik, Hizmet Kalitesi

Project Number

-

References

• Akdere, M., Top, M., & Tekingündüz, S. (2018). Examining patient perceptions of service quality in Turkish hospitals: The SERVPERF model. Total Quality Management & Business Excellence, 31(4), 342-352. https://doi.org/10.1080/14783363.2018.1427501
• Anekwe, T. D., & Rahkovsky, I. (2018). Self-management: a comprehensive approach to management of chronic conditions. American Journal of Public Health, 108(S6), S430-S436. https://doi.org/10.2105/AJPH.2014.302041
• Bandura A. (2004). Health promotion by social cognitive means. Health Education & Behavior, 31(2), 143–164. https://doi.org/10.1177/1090198104263660
• Berkman, N. D., Sheridan, S. L., Donahue, K. E., Halpern, D. J., & Crotty, K. (2011). Low health literacy and health outcomes: an updated systematic review. Annals of Internal Medicine, 155(2), 97-107. https://doi.org/10.7326/0003-4819-155-2-201107190-00005
• Bertram, M., Brandt, U. S., Hansen, R. K., & Svendsen, G. T. (2021). Does higher health literacy lead to higher trust in public hospitals?. International Journal for Equity in Health, 20, 1-15. https://doi.org/10.1186/s12939-021-01528-w
• Bhattad, P. B., & Pacifico, L. (2022). Empowering Patients: Promoting Patient Education and Health Literacy. Cureus, 14(7), e27336. https://doi.org/10.7759/cureus.27336
• Bilgel, N., Sarkut, P., Bilgel, H., & Ozcakir, A. (2017). Functional health literacy in a group of Turkish patients: A pilot study. Cogent Social Sciences, 3, 1287832. https://doi.org/10.1080/23311886.2017.1287832
• Bostock, S., & Steptoe, A. (2012). Association between low functional health literacy and mortality in older adults: longitudinal cohort study. BMJ, 344, e1602. https://doi.org/10.1136/bmj.e1602
• Brennan, N., Barnes, R., Calnan, M., Corrigan, O., Dieppe, P., & Entwistle, V. (2013). Trust in the health-care provider–patient relationship: a systematic mapping review of the evidence base. International Journal for Quality in Health Care, 25(6), 682-688. https://doi.org/10.1093/intqhc/mzt063
• Ceyhan, Y. Ş., ve Ünsal, A. (2017). The Validity and Reliability Study of Self-Efficacy Scale on the People with Chronic Diseases. Hemşirelikte Araştırma ve Geliştirme Dergisi, 19(2), 1-13.
• Comino, E. J., Davies, G. P., Krastev, Y., Haas, M., Christl, B., Furler, J., Raymont, A., & Harris, M. F. (2012). A systematic review of interventions to enhance access to best practice primary health care for chronic disease management, prevention and episodic care. BMC Health Services Research, 12, 415. https://doi.org/10.1186/1472-6963/12/415
• Cronin, J. J., & Taylor, S. A. (1992). Measuring service quality: a reexamination and extension. Journal of Marketing, 56(3), 55-68. https://doi.org/10.1177/002224299205600304
• Diamond, J. J., Becker, J. A., Arenson, C. A., Chambers, C. V., & Rosenthal, M. P. (2007). Development of a scale to measure adults' perceptions of health: Preliminary findings. Journal of Community Psychology, 35(5), 557-561. https://doi.org/10.1002/jcop.20164
• Ebrahimi Belil, F., Alhani, F., Ebadi, A., & Kazemnejad, A. (2018). Self-efficacy of people with chronic conditions: A qualitative directed content analysis. Journal of Clinical Medicine, 7(11), 411. https://doi.org/10.3390/jcm7110411
• Fan, Z. Y., Yang, Y., & Zhang, F. (2021). Association between health literacy and mortality: a systematic review and meta-analysis. Archives of Public Health, 79, 119. https://doi.org/10.1186/s13690-021-00648-7
• Farley H. (2020). Promoting self-efficacy in patients with chronic disease beyond traditional education: A literature review. Nursing Open, 7, 30–41.https://doi.org/10.1002/nop2.382
• Gilson L. (2006). Trust in health care: theoretical perspectives and research needs. Journal of Health Organization and Management, 20(5), 359–375. https://doi.org/10.1108/14777260610701768
• Huang, Y. M., Pecanac, K. E., & Shiyanbola, O. O. (2020). “Why am I not taking medications?” Barriers and facilitators of diabetes medication adherence across different health literacy levels. Qualitative Health Research, 30(14), 2331-2342. https://doi.org/10.1177/10497323209452
• Kadioglu, H., & Yildiz, A. (2012). Saglik Algisi Ölçegi'nin Türkçe Çevriminin Geçerlilik ve Güvenilirligi/Validity and Reliability of Turkish Version of Perception of Health Scale. Turkiye Klinikleri Journal of Medical Sciences, 32(1), 47-53. https://doi:10.5336/medsci.2010-21761
• Lorig, K., Stewart, A., Ritter, P., González, V., Laurent, D., & Lynch, J. (1996). Outcome measures for health education and other health care interventions. Thousand Oaks, CA: Sage Publications, p. 41-45.
• Mackey, L. M., Doody, C., Werner, E. L., & Fullen, B. (2016). Self-management skills in chronic disease management: what role does health literacy have?. Medical Decision Making, 36(6), 741-759. https://doi.org/10.1177/0272989X16638330
• Mahmoodi, R., Hassanzadeh, A., & Rahimi, M. (2021). Health literacy and its dimensions in elderly people in Farsan city, Iran. Journal of Education and Health Promotion, 10, 362. https://doi.org/10.4103/jehp.jehp_149_21
• Okyay, P, Abacıgil F., & Harlak, H. (2016) Türkiye Sağlik Okuryazarliği Ölçeği-32. Okyay P., Abacigil, F. Türkiye Sağlık Okuryazarlığı Ölçekleri Güvenilirlik ve Geçerlilik Çalışması içinde (43-61). T.C. Health Ministry 2016
• Paul, P., Hakobyan, M., & Valtonen, H. (2016). The association between self-perceived health status and satisfaction with healthcare services: Evidence from Armenia. BMC Health Services Research, 16, 67. https://doi.org/10.1186/s12913-016-1309-6
• Peters, M., Potter, C. M., Kelly, L., & Fitzpatrick, R. (2019). Self-efficacy and health-related quality of life: a cross-sectional study of primary care patients with multi-morbidity. Health and Quality of Life Outcomes, 17, 37. https://doi.org/10.1186/s12955-019-1103-3
• Protheroe, J., Whittle, R., Bartlam, B., Estacio, E. V., Clark, L., & Kurth, J. (2017). Health literacy, associated lifestyle and demographic factors in adult population of an English city: a cross‐sectional survey. Health Expectations, 20, 112-119. https://doi.org/10.1111/hex.12440
• Ratzan, S. C., & Parker, R. M. (2006). Health literacy—identification and response. Journal of Health Communication, 11, 713-715. https://doi.org/10.1080/10810730601031090
• Rodríguez, V., Andrade, A. D., García-Retamero, R., Anam, R., Rodríguez, R., Lisigurski, M., ... & Ruiz, J. G. (2013). Health literacy, numeracy, and graphical literacy among veterans in primary care and their effect on shared decision making and trust in physicians. Journal of Health Communication, 18, 273-289. https://doi.org/10.1080/10810730.2013.829137
• Schönfeld, M. S., Pfisterer-Heise, S., & Bergelt, C. (2021). Self-reported health literacy and medication adherence in older adults: a systematic review. BMJ Open, 11, e056307. https://doi.org/10.1136/bmjopen-2021-056307
• Sheeran, P., Maki, A., Montanaro, E., Avishai-Yitshak, A., Bryan, A., Klein, W. M., Miles, E., & Rothman, A. J. (2016). The impact of changing attitudes, norms, and self-efficacy on health-related intentions and behavior: A meta-analysis. Health Psychology, 35(11), 1178–1188. https://doi.org/10.1037/hea0000387
• Sørensen, K., Pelikan, J. M., Röthlin, F., Ganahl, K., Slonska, Z., Doyle, G., Fullam, J., Kondilis, B., Agrafiotis, D., Uiters, E., Falcon, M., Mensing, M., Tchamov, K., van den Broucke, S., Brand, H., & HLS-EU Consortium (2015). Health literacy in Europe: comparative results of the European health literacy survey (HLS-EU). European Journal of Public Health, 25(6), 1053-1058. https://doi.org/10.1093/eurpub/ckv043
• White, R. O., Osborn, C. Y., Gebretsadik, T., Kripalani, S., & Rothman, R. L. (2013). Health literacy, physician trust, and diabetes-related self-care activities in Hispanics with limited resources. Journal of Health Care for the Poor and Underserved, 24(4), 1756–1768. https://doi.org/10.1353/hpu.2013.0177
• Wu, S. F. V., Hsieh, N. C., Lin, L. J., & Tsai, J. M. (2016). Prediction of self‐care behaviour on the basis of knowledge about chronic kidney disease using self‐efficacy as a mediator. Journal of Clinical Nursing, 25(17-18), 2609-2618. https://doi.org/10.1111/jocn.13305